BETHANY K BURGE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060265

License Status

CANCELLED

Business

Title

First Name

BETHANY

Middle

Last Name

BURGE

Business Name

BETHANY K BURGE MD

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2016

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

04/30/2014